Li Haoran, Sahu Kamal K, Maughan Benjamin L
Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84108, USA.
Cancers (Basel). 2022 May 17;14(10):2460. doi: 10.3390/cancers14102460.
The use of immune checkpoint inhibitors (ICIs) is rapidly increasing as more combinations and clinical indications are approved in the field of genitourinary malignancies. Most immunotherapeutic agents being approved are for the treatment of renal cell carcinoma and bladder cancer, which mainly involve PD-1/PD-L1 and CTLA-4 pathways. There is an ongoing need for recognizing and treating immunotherapy-related autoimmune adverse effects (irAEs). This review aims to critically appraise the recent literature on the mechanism, common patterns, and treatment recommendations of irAEs in genitourinary malignancies. We review the epidemiology of these adverse effects as well as general treatment strategies. The underlying mechanisms will also be discussed. Diagnostic considerations including differential diagnosis are also included in this review.
随着越来越多的联合用药方案和临床适应症在泌尿生殖系统恶性肿瘤领域获批，免疫检查点抑制剂（ICI）的使用正在迅速增加。目前获批的大多数免疫治疗药物用于治疗肾细胞癌和膀胱癌，主要涉及PD-1/PD-L1和CTLA-4通路。识别和治疗免疫治疗相关的自身免疫不良反应（irAE）的需求一直存在。本综述旨在批判性地评估近期关于泌尿生殖系统恶性肿瘤中irAE的机制、常见模式和治疗建议的文献。我们回顾了这些不良反应的流行病学以及一般治疗策略。还将讨论潜在机制。本综述还包括诊断方面的考虑，包括鉴别诊断。
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